247 Diagnostic utility of molecular and imaging biomarkers 2 Meta-analysis of (semi-)quantitative USE Six studies performed (semi-)quantitative USE, involving 867 indeterminate thyroid nodules. Semi-quantitative USE was performed in a similar way: the strain ratio was calculated between the measured strains of a region of interest (ROI) of the thyroid nodule and a ROI of normal thyroid tissue [253, 255, 257, 278, 287]. Samir et al. performed quantitative shearwave USE by measuring shear wave velocity (Young modulus, in kPa) in three different planes [57]. Even though this technique differs from semi-quantitative USE, results of both techniques were pooled for the purpose of comparing qualitative USE to (semi-)quantitative USE as a whole. Low elasticity was demonstrated in 29.8% (258/867) of thyroid nodules. Estimated pooled sensitivity, specificity, positive LR and negative LR are 92.1% (95% CI: 53.6%-99.2%), 93.4% (95% CI: 85.5%-97.2%), 14.04 (95% CI: 5.2237.79) and 0.08 (95% CI: 0.01-0.75), respectively (Table 58, Figure 81 and Figure 82). For a given prevalence of malignancy of 15%, 25% or 40%, these results correspond to an estimated PPV and NPV of 71.2% (95% CI: 47.9%-87.0%) and 98.5% (95% CI: 88.3%-99.8%), 82.4% (95% CI: 63.5%- 92.6%) and 97.3% (95% CI: 80.0%-99.7%), or 90.3% (95% CI: 77.7%-96.2%) and 94.7% (95% CI: 66.7%-99.4%), respectively.
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